Rising cost of breast cancer testing, treatment equates to increased survival rates

A recent study revealed that the escalating cost associated with breast cancer care is paying dividends by way of significant improvements in patient outcomes, according to results published in the April issue of Health Affairs.

In the last 10 years, medical technologies aimed at fighting cancer have progressed rapidly, which in turn has created enormous costs surrounding cancer diagnosis and treatment. Breast cancer has the distinction of being the most financially burdensome malignancy on average, with total annual costs expected to rise as high as $20.5 billion by 2020. But it’s important to know what effect these inflated costs are having on breast cancer survival rates, according to lead author Aaron Feinstein, MD, of Yale University Medical Center, and colleagues. “Given the challenges of controlling costs and optimizing outcomes, it is critical to assess both temporal changes in the costs of breast cancer care and whether or not increases in costs are associated with better survival for women with breast cancer,” wrote Feinstein et al.

The researchers compared the survival rates among women ages 67–94 who were diagnosed with stage II or III breast cancer in 1994–96 or 2004–06 with the changes in care-related costs during that time span using the Surveillance, Epidemiology, and End Results (SEER) Program–Medicare linked database.

Their results showed that median cancer-related costs increased from $12,335 to $17,396 among patients with stage II breast cancer, and from $18,107 to $32,598 among women with stage III disease. The research team noted that the median cost of breast surgery declined during the timespan studied, while the median cost of radiation and chemotherapy increased dramatically, ultimately resulting in an overall rise in costs. This rise in costs was correlated with significant improvements in patient survival, with rates growing from 68 percent to 73 percent for stage II breast cancer patients and from 39 percent to 52 percent for those with stage III disease.

Going a step further, Feinstein and his team calculated the net cost of additional five-year survival for both stage II ($88,171) and stage III patients ($98,012). “Determining the incremental value of these improvements for the patient or society remains controversial,” the authors wrote, “and there is no consensus on the ideal way to calculate that value or its appropriate threshold.”

Despite the challenges, Feinstein and his colleagues remain confident in the value of their findings for substantiating the relationship between costs and progress and furthering efforts of treatment optimization. “These findings suggest that increases in cancer care costs have been accompanied by improved outcomes,” wrote Feinstein et al. “Future work should identify opportunities to optimize efficiency in cancer care.”